{"id":1063,"date":"2016-07-29T12:00:38","date_gmt":"2016-07-29T10:00:38","guid":{"rendered":"https:\/\/www.endoscopy-campus.com\/en\/bildergalerie\/die-nicht-ganz-normale-z-linie\/"},"modified":"2024-02-19T11:44:19","modified_gmt":"2024-02-19T10:44:19","slug":"die-nicht-ganz-normale-z-linie","status":"publish","type":"bildergalerie","link":"https:\/\/www.endoscopy-campus.com\/en\/bildergalerie\/die-nicht-ganz-normale-z-linie\/","title":{"rendered":"When the Z-line is not completely normal"},"content":{"rendered":"<h2 class=\"zentrierte-ueberschrift-mit-linie\">Case 1<\/h2>\n<div id='gallery-1' class='gallery galleryid-1063 gallery-columns-2 gallery-size-large'><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"400\" height=\"309\" src=\"https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall1_1.jpg\" class=\"attachment-large size-large\" alt=\"\" srcset=\"https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall1_1.jpg 400w, https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall1_1-150x116.jpg 150w, https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall1_1-300x232.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/>\n\t\t\t<\/div><\/figure><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"400\" height=\"309\" src=\"https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall1_2.jpg\" class=\"attachment-large size-large\" alt=\"\" srcset=\"https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall1_2.jpg 400w, https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall1_2-150x116.jpg 150w, https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall1_2-300x232.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/>\n\t\t\t<\/div><\/figure>\n\t\t<\/div>\n\n<p><span class=\"einfarbig-blau\"><b>Left:<\/b><\/span> a patient with a focal lump at the Z-line. The biopsy showed that there was low-grade intraepithelial neoplasia (LGIN) \/ low-grade dysplasia.<br \/>\n<span class=\"einfarbig-blau\"><b>Right:<\/b><\/span> In close-up and with NBI, minor structural irregularities appear. The extent to which these correlate with the histology remains unclear. However, endotherapy is indicated when there is histologically confirmed LGIN.<\/p>\n<h2 class=\"zentrierte-ueberschrift-mit-linie\">Case 2<\/h2>\n<div id='gallery-2' class='gallery galleryid-1063 gallery-columns-2 gallery-size-large'><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"400\" height=\"309\" src=\"https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall2_1.jpg\" class=\"attachment-large size-large\" alt=\"\" srcset=\"https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall2_1.jpg 400w, https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall2_1-150x116.jpg 150w, https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall2_1-300x232.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/>\n\t\t\t<\/div><\/figure>\n\t\t<\/div>\n\n<p>A patient with a small lump at the Z-line, which resembles an adenoma. Histological analysis after mucosectomy showed that it was a mucosal carcinoma.<\/p>\n<p>&nbsp;<\/p>\n<h2 class=\"zentrierte-ueberschrift-mit-linie\">Case 3<\/h2>\n<div id='gallery-3' class='gallery galleryid-1063 gallery-columns-2 gallery-size-large'><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"400\" height=\"309\" src=\"https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall3_1.jpg\" class=\"attachment-large size-large\" alt=\"\" srcset=\"https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall3_1.jpg 400w, https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall3_1-150x116.jpg 150w, https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall3_1-300x232.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/>\n\t\t\t<\/div><\/figure>\n\t\t<\/div>\n\n<p>A patient with biopsy findings of high-grade intraepithelial neoplasia (HGIN) \/ high-grade dysplasia and only slight reddening (visible in inversion, arrow).<\/p>\n<div id='gallery-4' class='gallery galleryid-1063 gallery-columns-2 gallery-size-large'><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"400\" height=\"309\" src=\"https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall3_2.jpg\" class=\"attachment-large size-large\" alt=\"\" srcset=\"https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall3_2.jpg 400w, https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall3_2-150x116.jpg 150w, https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall3_2-300x232.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/>\n\t\t\t<\/div><\/figure><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"400\" height=\"309\" src=\"https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall3-3.jpg\" class=\"attachment-large size-large\" alt=\"\" srcset=\"https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall3-3.jpg 400w, https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall3-3-150x116.jpg 150w, https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall3-3-300x232.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/>\n\t\t\t<\/div><\/figure>\n\t\t<\/div>\n\n<p>Near the Z-line at the center on NBI and after acetic acid staining, focal structural changes are seen that produce an irregular pattern with small foci. After EMR, the lesion was found to be a T1m3 carcinoma.<\/p>\n<p>&nbsp;<\/p>\n<h2 class=\"zentrierte-ueberschrift-mit-linie\">Case 4<\/h2>\n<div id='gallery-5' class='gallery galleryid-1063 gallery-columns-2 gallery-size-large'><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"400\" height=\"309\" src=\"https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall4_1.jpg\" class=\"attachment-large size-large\" alt=\"\" srcset=\"https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall4_1.jpg 400w, https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall4_1-150x116.jpg 150w, https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall4_1-300x232.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/>\n\t\t\t<\/div><\/figure>\n\t\t<\/div>\n\n<p>A lump above the Z-line, with no other irregularities on the macroscopic view.<\/p>\n<div id='gallery-6' class='gallery galleryid-1063 gallery-columns-2 gallery-size-large'><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"400\" height=\"309\" src=\"https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall4_2.jpg\" class=\"attachment-large size-large\" alt=\"\" srcset=\"https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall4_2.jpg 400w, https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall4_2-150x116.jpg 150w, https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall4_2-300x232.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/>\n\t\t\t<\/div><\/figure><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"400\" height=\"309\" src=\"https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall4_3.jpg\" class=\"attachment-large size-large\" alt=\"\" srcset=\"https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall4_3.jpg 400w, https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall4_3-150x116.jpg 150w, https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall4_3-300x232.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/>\n\t\t\t<\/div><\/figure>\n\t\t<\/div>\n\n<p>On NBI and with acetic acid staining, similar structural irregularities are seen at the Z-line, although not as marked as in Case 3. The impression is one of undermining growth under the Z-line extending to the small island at the top (left image).<\/p>\n<p>&nbsp;<\/p>\n<h2 class=\"zentrierte-ueberschrift-mit-linie\">Case 5<\/h2>\n<div id='gallery-7' class='gallery galleryid-1063 gallery-columns-2 gallery-size-large'><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"400\" height=\"309\" src=\"https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall5_1.jpg\" class=\"attachment-large size-large\" alt=\"\" srcset=\"https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall5_1.jpg 400w, https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall5_1-150x116.jpg 150w, https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall5_1-300x232.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/>\n\t\t\t<\/div><\/figure>\n\t\t<\/div>\n\n<p>Z-line initially unremarkable.<\/p>\n<div id='gallery-8' class='gallery galleryid-1063 gallery-columns-2 gallery-size-large'><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"400\" height=\"309\" src=\"https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall5_2.jpg\" class=\"attachment-large size-large\" alt=\"\" srcset=\"https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall5_2.jpg 400w, https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall5_2-150x116.jpg 150w, https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall5_2-300x232.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/>\n\t\t\t<\/div><\/figure><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"400\" height=\"309\" src=\"https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall5_3.jpg\" class=\"attachment-large size-large\" alt=\"\" srcset=\"https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall5_3.jpg 400w, https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall5_3-150x116.jpg 150w, https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/2016\/07\/Die-nicht-ganz-normale-Z-Linie-image_fall5_3-300x232.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/>\n\t\t\t<\/div><\/figure>\n\t\t<\/div>\n\n<p>With more insufflation, a focal lump is again seen at the cardia at the 12-o\u2019clock position. The biopsy showed high-grade intraepithelial neoplasia (HGIN) \/ high-grade dysplasia.<\/p>\n<p>On NBI and with acetic acid staining, slight structural irregularities and again the impression of the squamous epithelium being undermined were seen.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Depending on the patient\u2019s degree of sedation and the examiner\u2019s level of experience, carrying out a precise examination of the Z-line may not be very easy (see \u201cEndoscopic examination of a normal Z-line\u201d). However, it is worth taking biopsies from minimal focal changes, areas of reddening, bumps and irregularities, even when they have an \u201cinflammatory\u201d appearance. <\/p>\n","protected":false},"featured_media":1036,"template":"","categories":[77,93],"tags":[3891,1009,234,1011,199,533,532,974,1010],"ec-magazin-ausgaben":[118],"sponsoren-erwaehnung":[],"autor":[],"class_list":["post-1063","bildergalerie","type-bildergalerie","status-publish","has-post-thumbnail","hentry","category-galleries","category-upper-gi-tract","tag-acetic-acid","tag-barrett-esophagus","tag-dysplasia","tag-esophageal-cancer","tag-hgin-en-2","tag-high-grade-inraepithelial-neoplasia","tag-low-grade-intraepithelial-neoplasia","tag-metaplasia","tag-mucosal-cancer","ec-magazin-ausgaben-ec-magazine-2015-02"],"_links":{"self":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/bildergalerie\/1063","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/bildergalerie"}],"about":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/types\/bildergalerie"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/media\/1036"}],"wp:attachment":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/media?parent=1063"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/categories?post=1063"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/tags?post=1063"},{"taxonomy":"ec-magazin-ausgaben","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/ec-magazin-ausgaben?post=1063"},{"taxonomy":"sponsoren-erwaehnung","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/sponsoren-erwaehnung?post=1063"},{"taxonomy":"autor","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/autor?post=1063"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}